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Bieth E, Nectoux J, Girardet A, Gruchy N, Mittre H, Laurans M, Guenet D, Brouard J, Gerard M. Genetic counseling for cystic fibrosis: A basic model with new challenges. Arch Pediatr 2020; 27 Suppl 1:eS30-eS34. [PMID: 32172934 DOI: 10.1016/s0929-693x(20)30048-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
While the goals of genetic counseling for cystic fibrosis - delivering relevant information on the risk of recurrence and nondirectional support of couples at risk in their reproductive choices - have not changed fundamentally, the practice has evolved considerably in the last decade, growing more complex to face new challenges but also proving more effective. Many factors have contributed to this evolution: technical progress in the exploration of the genome (new generation sequencing) and in reproductive medicine, but also societal developments promoting access to genetic information and the professionalization of genetic counselors in France. The prospect of expanded pre-conception screening of at-risk couples makes genetic counselors major actors not only in medical care centers, but also in modern society by contributing to genetic education among citizens. © 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- E Bieth
- Génétique Médicale, CHU Toulouse, France.
| | - J Nectoux
- Service de génétique et biologie moléculaires, CHU Paris Centre - Hôpital Cochin, Site Cochin, Paris, France
| | - A Girardet
- Génétique Moléculaire, CHU Montpellier, France
| | - N Gruchy
- Génétique Médicale, CHR Clemenceau, CHU de Caen, Avenue Côte de Nacre, France
| | - H Mittre
- Génétique Médicale, CHR Clemenceau, CHU de Caen, Avenue Côte de Nacre, France
| | - M Laurans
- CRCM, CHU de Caen, Avenue Côte de Nacre, France
| | - D Guenet
- Laboratoire de Biochimie, Dépistage néonatal, CHU de Caen, Avenue Côte de Nacre, France
| | - J Brouard
- Pédiatrie, CHU de Caen, Avenue Côte de Nacre, France
| | - M Gerard
- Génétique Médicale, CHR Clemenceau, CHU de Caen, Avenue Côte de Nacre, France
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Gruchy N, Vialard F, Blondeel E, Le Meur N, Joly-Hélas G, Chambon P, Till M, Herbaut-Graux M, Vigouroux-Castera A, Coussement A, Lespinasse J, Amblard F, Jimenez M, Lebel Roy Camille L, Carré-Pigeon F, Flori E, Mugneret F, Jaillard S, Yardin C, Harbuz R, Collonge Rame M, Vago P, Valduga M, Leporrier N. Pregnancy outcomes of prenatally diagnosed Turner syndrome: a French multicenter retrospective study including a series of 975 cases. Prenat Diagn 2014; 34:1133-8. [DOI: 10.1002/pd.4439] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/10/2014] [Accepted: 06/17/2014] [Indexed: 12/28/2022]
Affiliation(s)
- N. Gruchy
- Laboratoire de cytogénétique prénatale, Service de Génétique; CHU Côte de Nacre, UFR de Médecine Caen; Caen Cedex 9 France
| | - F. Vialard
- Laboratoire d'Histologie, Embryologie, Biologie de la Reproduction, Cytogénétique et Génétique médicale; CHI Poissy Saint Germain; Versailles France
| | - E. Blondeel
- Laboratoire d'Histologie, Embryologie, Biologie de la Reproduction, Cytogénétique et Génétique médicale; CHI Poissy Saint Germain; Versailles France
| | - N. Le Meur
- Etablissement Français du Sang Normandie; Bois-Guillaume Cedex France
| | - G. Joly-Hélas
- Laboratoire d'histologie, cytogénétique et biologie de la reproduction; Fédération de Génétique CHU de Rouen, Faculté de Médecine; Rouen France
| | - P. Chambon
- Laboratoire d'histologie, cytogénétique et biologie de la reproduction; Fédération de Génétique CHU de Rouen, Faculté de Médecine; Rouen France
| | - M. Till
- Service de cytogénétique, GHE; CBPE Hôpitaux de Lyon; Bron Cedex 2 France
| | | | | | - A. Coussement
- Groupe hospitalier Cochin Saint Vincent de Paul, APHP; Université Paris Descartes, Faculté de Médecine; Paris France
| | - J. Lespinasse
- Service de Génétique; Hôpital de Chambéry; Chambéry Cedex France
| | - F. Amblard
- Service de génétique chromosomique; CHU de Grenoble; Grenoble France
| | - M. Jimenez
- Service de Génétique UF Cytogénétique; CHRU de Tours; Tours Cedex 9 France
| | | | | | - E. Flori
- Service de Cytogénétique; Hôpital de Hautepierre; Strasbourg Cedex France
| | - F. Mugneret
- Laboratoire de cytogénétique; CHU de Dijon; Dijon France
| | - S. Jaillard
- Service de cytogénétique et biologie cellulaire; CHU Pontchaillou; Rennes Cedex 2 France
| | - C. Yardin
- Service d'Histologie, Cytologie et Cytogénétique; Hôpital de la Mère et de l'Enfant, CHU de Limoges; Limoges Cedex France
| | - R. Harbuz
- Laboratoire de Génétique Chromosomique, Service de Génétique; CHU de Poitiers; Poitiers France
| | - M. Collonge Rame
- Service de génétique biologique, histologie, biologie du développement et de la reproduction; CHRU Besançon, Hôpital Saint-Jacques; Besançon Cedex France
| | - P. Vago
- Cytogénétique Médicale; CHU Estaing Cytologie Histologie Embryologie Cytogénétique; Clermont-ferrand Cedex1 France
| | - M. Valduga
- Laboratoire de génétique médicale, Service de cytogénétique et génétique moléculaire; CHU de Nancy; Vandoeuvre-Les-Nancy France
| | - N. Leporrier
- Laboratoire de cytogénétique prénatale, Service de Génétique; CHU Côte de Nacre, UFR de Médecine Caen; Caen Cedex 9 France
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Gruchy N, Bigot N, Jeanne Pasquier C, Read MH, Odent S, Galera P, Leporrier N. Involvement and alteration of the Sonic Hedgehog pathway is associated with decreased cholesterol level in trisomy 18 and SLO amniocytes. Mol Genet Metab 2014; 112:177-82. [PMID: 24742993 DOI: 10.1016/j.ymgme.2014.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 03/24/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Trisomy 18 and Smith-Lemli-Opitz syndrome are two polymalformative conditions in which a cholesterol defect has been noted. When they occur prenatally, they are associated with a decreased maternal unconjugated estriol (uE(3)) level. Cholesterol plays an essential role in the Sonic Hedgehog pathway, allowing Shh protein maturation leading to its maximal activity. Many malformations in these two syndromes occur in Shh dependent tissues. We thus sought to assess whether a cholesterol defect could affect the Shh pathway and explain some of the observed malformations. MATERIALS AND METHODS We selected 14 cases of trisomy 18 and 3 cases of SLO in which the maternal uE(3) level was decreased and reported malformations were observed after fetopathological examination. We correlated the number of malformations with maternal uE(3) level. We then carried out cholesterol concentrations in separate culture media consisting of trisomy 18, SLO and control amniocytes. Finally, we analyzed the Shh pathway by testing the gene expression of several Shh components: GLI transcription factors, BMP2, BMP4, TGFβ1, COL1A1 and COL1A2. RESULTS AND DISCUSSION There was an inverse correlation between phenotypic severity and maternal uE(3) levels in SLO and trisomy 18. The cholesterol levels in the amniocyte culture media were correlated with maternal uE3 levels and were significantly lower in T18 and SLO amniocytes, reflecting cholesterol defects. There was an alteration in the Shh pathway since expression of several genes was decreased in T18 and SLO amniocytes. However, these cholesterol defects were not solely responsible for the altered Shh pathway and the malformations observed.
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Affiliation(s)
- N Gruchy
- Laboratoire de cytogénétique prénatale, service de Génétique, avenue Côte de Nacre, CHU Caen, UFR médecine, 14033 Caen cedex 9, France.
| | - N Bigot
- Laboratoire "Microenvironnement cellulaire et pathologie" (MILPAT) EA 4652, UFR Médecine Caen, avenue Côte de Nacre, 14033 Caen cedex 9, France.
| | - C Jeanne Pasquier
- Service d'Anatomie pathologique, CHU Caen, UFR Médecine, 14033 Caen cedex 9, France.
| | - M H Read
- Service de biochimie métabolique, CHU Caen, UFR Médecine, 14033 Caen cedex 9, France.
| | - S Odent
- Génétique des pathologies liées au développement, CNRS, UMR6290, UFR Médecine, Rennes, France.
| | - P Galera
- Laboratoire "Microenvironnement cellulaire et pathologie" (MILPAT) EA 4652, UFR Médecine Caen, avenue Côte de Nacre, 14033 Caen cedex 9, France.
| | - N Leporrier
- Laboratoire de cytogénétique prénatale, service de Génétique, avenue Côte de Nacre, CHU Caen, UFR médecine, 14033 Caen cedex 9, France.
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Besseau-Ayasse J, Violle-Poirsier C, Bazin A, Gruchy N, Moncla A, Girard F, Till M, Mugneret F, Coussement A, Pelluard F, Jimenez M, Vago P, Portnoï MF, Dupont C, Beneteau C, Amblard F, Valduga M, Bresson JL, Carré-Pigeon F, Le Meur N, Tapia S, Yardin C, Receveur A, Lespinasse J, Pipiras E, Beaujard MP, Teboul P, Brisset S, Catty M, Nowak E, Douet Guilbert N, Lallaoui H, Bouquillon S, Gatinois V, Joly-Helas G, Prieur F, Cartault F, Martin D, Kleinfinger P, Molina Gomes D, Doco-Fenzy M, Vialard F. A French collaborative survey of 272 fetuses with 22q11.2 deletion: ultrasound findings, fetal autopsies and pregnancy outcomes. Prenat Diagn 2014; 34:424-30. [PMID: 24395195 DOI: 10.1002/pd.4321] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/02/2014] [Accepted: 01/02/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The 22q11.2 deletion (del22q11.2) is one of the most common microdeletions. We performed a collaborative, retrospective analysis in France of prenatal diagnoses and outcomes of fetuses carrying the del22q11.2. METHODS A total of 272 fetuses were included. Data on prenatal diagnosis, ultrasound findings, pathological features, outcomes and inheritance were analyzed. RESULTS The mean time of prenatal diagnosis was 25.6 ± 6 weeks of gestation. Most of the diagnoses (86.8%) were prompted by abnormal ultrasound findings [heart defects (HDs), in 83.8% of cases]. On fetal autopsy, HDs were again the most common disease feature, but thymus, kidney abnormalities and facial dysmorphism were also described. The deletion was inherited in 27% of cases. Termination of pregnancy (TOP) occurred in 68.9% of cases and did not appear to depend on the inheritance status. However, early diagnosis was associated with a higher TOP rate. CONCLUSION This is the largest cohort of prenatal del22q11.2 diagnoses. As in postnatally diagnosed cases, HDs were the most frequently observed abnormalities. However, thymus and kidney abnormalities and polyhydramnios should also be screened for in the prenatal diagnosis of del22q11.2. Only the time of diagnosis appeared to be strongly associated with the pregnancy outcome: the earlier the diagnosis, the higher the TOP rate.
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Affiliation(s)
- J Besseau-Ayasse
- Cytogenetics Laboratory, Poissy St Germain Hospital, Poissy, France; UFR des Sciences de la Santé, UVSQ, Versailles, France
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Gruchy N, Vialard F, Decamp M, Choiset A, Rossi A, Le Meur N, Moirot H, Yardin C, Bonnet-Dupeyron MN, Lespinasse J, Herbaut-Graux M, Till M, Layet V, Leporrier N. Pregnancy outcomes in 188 French cases of prenatally diagnosed Klinefelter syndrome. Hum Reprod 2011; 26:2570-5. [DOI: 10.1093/humrep/der193] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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